Total colectomy and ileoanal endorectal pull-through for ulcerative colitis and familial polyposis

ABSTRACT

Thirteen young adults [8 familial polyposis and 5 ulcerative colitis] underwent total colectomy and straight endorectal ileoanal pull- through operation. They were 7 males and 6 females. Their age ranged from 18 to 32 years. The diagnosis was confirmed by histopathological examination. Standard bowel preparation was done. Follow up period ranged from 6 to 36 months. There were no operative or postoperative mortality, also there was no major complications. Two patients developed pelvic cellulitis, which were responded to antibiotic therapy, 3 patients developed minor wound sepsis, one patient developed adhesive intestinal obstruction, which resolved by nasogastric suction. Three patients developed stenosis of the anastomotic line which was relieved by digital dilation. In one patient loop ileostomy was done because he was not satisfied from the operation. Rectal sphincter tone had been good on physical examination in all patients. All patients showed normal bladder function. There was definite increase in stool frequency. In spite of this, it was accepted by the patient as a price to avoid ileostomy. The absence of major complications and the accepted functional and social results supported the recommendation of these procedures as an acceptable alternative to proctocolectomy and permanent ileostomy in patients with familial polyposis and ulcerative colitis